在过去的5年里,对骨髓瘤的细胞生物学和分子生物学已获得了新的认识,从而以前的终末分化B细胞恶性肿瘤的概念正让位于下述的新概念:一种主要表露于B细胞系成熟阶段的早期造血干细胞疾患。基因型分析目前还不能确定本病的特异性核型异常。用流式细胞仪进行核DNA含量分析已证实80%的病人有非整倍体,细胞遗传学的研究也证实,DNA-亚二倍体经常只生成轻链,并且对标准疗法耐药,最近,6号染色体长臂缺失已被认为与溶骨性损害有关。一株抗阿霉素的骨髓瘤细胞系(8226/Dox)显示多种抗药表型,它有一个7号染色体长臂缺失,而这正是P-糖蛋白的基因位点。浆细胞核型如此异常的复杂性提示克隆性演变必定是常见的。 In the past five years new insights have gained on the cellular biology and molecular biology of myeloma so that the concept of previous terminally differentiated B cell malignancies is giving way to the new concept of a major Early hematopoietic stem cell disorders exposed to the maturation stage of B cell lines. Genotyping is not yet able to determine the specific karyotype of the disease. Analysis of nuclear DNA using flow cytometry has confirmed aneuploidy in 80% of patients, and cytogenetic studies also confirm that DNA-subdiploids often only produce light chains and are resistant to standard therapies, most recently , Chromosome 6 long arm deletion has been considered associated with osteolytic lesions. A doxorubicin-resistant myeloma cell line (8226 / Dox) shows a multi-drug resistant phenotype with a long arm deletion on chromosome 7, which is exactly the P-glycoprotein gene locus. The complexity of plasma cell karyotypes suggests that clonal evolution must be common.